The commentary of a board certified psychiatrist/sleep specialist/internist

Monday, April 21, 2008

Hospital Medical Staff Should not be Treated like Employees

Bob Wachter recently wrote about the different disciplinary treatment of doctors and nurses, when both committ a HIPPA violation (in this case, looked at Britney Spears medical records):

of the 53 people caught snooping, 18 of the non-doctors resigned, retired, or were dismissed, while no physicians left the staff.

Wachter acknowledges that nurses, therapists, etc are hospital employees, while physicians have traditionally in private practice and have not been in an employee/employer relationship with the hospital:

These forces quite logically led hospitals to develop two parallel systems of governance, rules, and enforcement: one for physicians, and another for everybody else.

He is in favor of peer review for matters requiring clinical judgement, but feels that for violations of unambiguous rules and policies...there is no reason that the standards for physicians and other staff should be different.----------------------------------------------Here are my thoughts on the matter:While not excusing the actions of the doctors who looked at Britney's records, I do not think that doctors should be treated like employees (except for the rare cases in which they are actually employees of the hospital). I personally would resign from the medical staff of any hospital that tried to treat its staff physicians in such a matter. Treating doctors the same as hospital employees makes about as much sense as a law firm treating its partners the same as its secretaries. It would make more sense to treat hospital CEO's like the hospital's maintenance staff than to treat doctors like nurses.Doctors are the ones who send their patients to hospitals. If a hospital doesn't treat me well, I will send the patients who have entrusted themselves to my care to a different hospital (for those who are wondering what type of patients I send to the hospital, given that I am mostly an outpt sleep doc, let me just say that hospitals today do much more than inpatient care- they provide outpt lab testing, imaging studies, sleep studies, etc. I do occasionally help cover a local psychiatric hospital).